Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania
Santos, Susana; Eekhout, Iris; Voerman, Ellis; Gaillard, Romy; Barros, Henrique; Charles, Marie-Aline; Chatzi, Leda; Chevrier, Cécile; Chrousos, George P; Corpeleijn, Eva; Costet, Nathalie; Crozier, Sarah; Doyon, Myriam; Eggesbø, Merete; Fantini, Maria Pia; Farchi, Sara; Forastiere, Francesco; Gagliardi, Luigi; Georgiu, Vagelis; Godfrey, Keith M; Gori, Davide; Grote, Veit; Hanke, Wojciech; Hertz-Picciotto, Irva; Heude, Barbara; Hivert, Marie-France; Hryhorczuk, Daniel; Huang, Rae-Chi; Inskip, Hazel; Jusko, Todd A; Karvonen, Anne M; Koletzko, Berthold; Küpers, Leanne K; Lagström, Hanna; Lawlor, Debbie A; Lehmann, Irina; Lopez-Espinosa, Maria-Jose; Magnus, Per; Majewska, Renata; Mäkelä, Johanna; Manios, Yannis; McDonald, Sheila W; Mommers, Monique; Morgen, Camilla S; Moschonis, George; Murínová, Ľubica; Newnham, John; Nohr, Ellen A; Andersen, Anne-Marie Nybo; Oken, Emily; Oostvogels, Adriëtte J J M; Pac, Agnieszka; Papadopoulou, Eleni; Pekkanen, Juha; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Rifas-Shiman, Sheryl L; Roeleveld, Nel; Santa-Marina, Loreto; Santos, Ana C; Smit, Henriette A; Sørensen, Thorkild I A; Standl, Marie; Stanislawski, Maggie; Stoltenberg, Camilla; Thiering, Elisabeth; Thijs, Carel; Torrent, Maties; Tough, Suzanne C; Trnovec, Tomas; van Gelder, Marleen M H J; van Rossem, Lenie; von Berg, Andrea; Vrijheid, Martine; Vrijkotte, Tanja G M; Zvinchuk, Oleksandr; van Buuren, Stef; Jaddoe, Vincent W V
(2018) BMC Medicine, volume 16, issue 1
(Article)
Abstract
BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We
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aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.
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Keywords: Weight gain, Pregnancy, Charts, References, General Medicine
ISSN: 1741-7015
Publisher: BioMed Central
Note: Funding Information: Lepeule, G. Magnin, L. Marchand, C. Nabet, F Pierre, R. Slama, M.J. Saurel-Cubizolles, M. Schweitzer, and O. Thiebaugeorges. FCOU The authors wish to acknowledge the University of Illinois at Chicago School of Public Health’s Louise Hamilton Kyiv Data Management Center for their assistance in the data management for FCOU study. GASPII The authors acknowledge the families involved in the study. GECKO Drenthe The authors are grateful to the families who took part in the GECKO Drenthe study, the midwives, gynecologists, nurses, and GPs for their help for recruitment and measurement of participants, and the whole team from the GECKO Drenthe study. Generation R The authors gratefully acknowledge the contribution of general practitioners, hospitals, midwives, and pharmacies in Rotterdam. Generation XXI The authors gratefully acknowledge the families enrolled in Generation XXI for their kindness, all members of the research team for their enthusiasm and perseverance, and the participating hospitals and their staff for their help and support. GENESIS The authors thank the Genesis research group which was comprised from Evdokia Oikonomou, Vivian Detopoulou, Christine Kortsalioudaki, Margarita Bartsota, Thodoris Liarigkovinos, and Christos Vassilopoulos. Gen3G The authors acknowledge the support form clinical and research staff from blood sampling in pregnancy clinic at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) for their help in recruitment, and the CHUS biomedical laboratory for performing assays. GINIplus The authors thank all the families for their participation in the GINIplus study. Furthermore, the authors thank all members of the GINIplus Study Group for their excellent work. The GINIplus Study group consists of the following: Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg (Heinrich J, Brüske I, Schulz H, Flexeder C, Zeller C, Standl M, Schnappinger M, Ferland M, Thiering E, Tiesler C); Department of Pediatrics, Marien-Hospital, Wesel (Berdel D, von Berg A); Ludwig-Maximilians-University of Munich, Dr. von Hauner Children’s Hospital (Koletzko S); Child and Adolescent Medicine, University Hospital rechts der Isar of the Technical University Munich (Bauer CP, Hoffmann U); IUF-Environmental Health Research Institute, Düsseldorf (Schikowski T, Link E, Klümper C, Krämer U, Sugiri D). HUMIS The authors thank the mothers who participated in the study and the Norwegian Research Council for their continuous support through several grants. INMA-Valencia The authors would particularly like to thank all the participants for their generous collaboration. INMA-Gipuzkoa The authors thank the children and parents who participated to the INMA-Gipuzkoa study. INMA-Menorca The authors thank all the participants for their generous collaboration. The authors are grateful to Mireia Garcia, Maria Victoria Estraña, Maria Victoria Iturriaga, Cristina Capo, and Josep LLuch for their assistance in contacting the families and administering the questionnaires. KOALA The authors thank the children and parents who participated to the KOALA study. Krakow Cohort The authors acknowledge Jagiellnonian University Medical College in Krakow and Columbia University in New York. Principal investigator: Prof. FP Perera; co-investigator: Prof. W Jedrychowski. LISAplus The authors thank all the families for their participation in the LISAplus study. Furthermore, the authors thank all members of the LISAplus Study Group for their excellent work. The LISAplus Study group consists of the following: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology I, Munich (Heinrich J, Schnappinger M, Brüske I, Ferland M, Schulz H, Zeller C, Standl M, Thiering E, Tiesler C, Flexeder C); Department of Pediatrics, Municipal Hospital “St. Georg”, Leipzig (Borte M, Diez U, Dorn C, Braun E); Marien Hospital Wesel, Department of Pediatrics, Wesel (von Berg A, Berdel D, Stiers G, Maas B); Pediatric Practice, Bad Honnef (Schaaf B); Helmholtz Centre of Environmental Research–UFZ, Department of Environmental Immunology/Core Facility Studies, Leipzig (Lehmann I, Bauer M, Röder S, Schilde M, Nowak M, Herberth G, Müller J); Technical University Munich, Department of Pediatrics, Munich (Hoffmann U, Paschke M, Marra S); Clinical Research Group Molecular Dermatology, Department of Dermatology and Allergy, Technische Universität München (TUM), Munich (Ollert M, J. Grosch). LUKAS The authors thank all the families for their participation in the study. The authors are grateful to Raija Juntunen, Asko Vepsäläinen, Pekka Tiittanen, and Timo Kauppila for their contribution to the data collection and data management. MoBa The authors are grateful to all the participating families in Norway who take part in this on-going cohort study. NINFEA The authors thank all families participating in the NINFEA cohort. PÉLAGIE The authors thank the gynecologists, obstetricians, ultrasonographers, midwives, pediatricians, and families who participated in the study. PIAMA The authors thank the PIAMA participants for their ongoing collaboration. Piccolipiù The authors acknowledge the Piccolipiù Working Group and the families involved in the study. PRIDE Study The authors thank the mothers and infants who participate in this ongoing cohort study, as well as all midwives, gynecologists, and general practitioners for their contributions to the data collection. Project Viva The authors thank the Project Viva mothers, children, and families for their ongoing participation. RAINE Study The authors would like to acknowledge the Raine Study participants and their families. We would also like to acknowledge the Raine Study Team for study co-ordination and data collection, and the NH&MRC for their long-term contribution to funding the study over the last 29 years. REPRO_PL The authors would particularly like to thank all the cohort participants for their collaboration. RHEA The authors would particularly like to thank all the cohort participants for their generous collaboration. Slovak PCB study The authors thank the Slovak PCB study participants for their ongoing cooperation. STEPS The authors are grateful to all the families who took part in STEPS study. SWS The authors are grateful to the women of Southampton who gave their time to take part in the Southampton Women’s Survey and to the research nurses and other staff who collected and processed the data. Funding Information: Keith M. Godfrey has received reimbursement for speaking at conferences sponsored by companies selling nutritional products and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec, and Danone. Debbie A. Lawlor has received support from Roche Diagnostics and Medtronic in relation to biomarker research that is not related to the research presented in this paper. Andrea von Berg has received reimbursement for speaking at symposia sponsored by Nestlé and Mead Johnson, who partly financially supported the 15 years follow-up examination of the GINIplus study. The rest of the authors reported no conflicts of interest. Funding Information: ABCD This work was supported by the Netherlands Organization for Health Research and Development (ZonMw) (TOP grant, 40-00812-98-11010). Publisher Copyright: © 2018 The Author(s).
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